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Your search keyword '"Gathen, Martin"' showing total 14 results
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14 results on '"Gathen, Martin"'

4. Acetabular defects in revision hip arthroplasty: a therapy-oriented classification

Author

Wirtz, Dieter Christian, Jaenisch, Max, Osterhaus, Thiemo Antonius, Gathen, Martin, Wimmer, Matthias, Randau, Thomas Martin, Schildberg, Frank Alexander, and Rössler, Philip Peter

Subjects
Reoperation, Hip, Revision, Arthroplasty, Replacement, Hip, Acetabulum, General Medicine, Paprosky, Hip Arthroplasty, Classification, Arthroplasty, Postoperative Complications, Practice Guidelines as Topic, Humans, Orthopedics and Sports Medicine, Surgery, Hip Prosthesis, Bone Diseases
Abstract

Introduction The treatment of severe acetabular bone loss remains a difficult challenge. No classification system is available that combines intuitive use, structured design and offers a therapeutic recommendation according to the current literature and modern state of the art treatment options. The goal of this study is to introduce an intuitive, reproducible and reliable guideline for the evaluation and treatment of acetabular defects. Methods The proposed Acetabular Defect Classification (ADC) is based on the integrity of the acetabular rim and supporting structures. It consists of 4 main types of defects ascending in severity and subdivisions narrowing down-defect location. Type 1 presents an intact acetabular rim, type 2 includes a noncontained defect of the acetabular rim ≤ 10 mm, in type 3 the rim defect exceeds 10 mm and type 4 includes different kinds of pelvic discontinuity. A collective of 207 preoperative radiographs were graded according to ADC and correlated with intraoperative findings. Additionally, a randomized sample of 80 patients was graded according to ADC by 5 observers to account for inter- and intra-rater reliability. Results We evaluated the agreement of preoperative, radiographic grading and intraoperative findings presenting with a k value of 0.74. Interobserver agreement presented with a k value of 0.62 and intraobserver at a k value of 0.78. Conclusion The ADC offers an intuitive, reliable and reproducible classification system. It guides the surgeon pre- and intraoperatively through a complex field of practice.

Published
2020

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